West Virginia Democrat. [volume] (Charles Town, W. Va.) 1885-1890, 1887-12-23
CARELESS DOCTORS.
cRlMINALLY SERIOUS SLIPS MADE
IN WRITING. PRESCRIPTIONS.

compromising morphine Tor qulnlne, Iauu-
Rnum for paregoric or oxalic acid for EPSON
salts. How seldom do we hear of the criminal
carelessness or murderous errors made by
physicians themselves in writing their pre-
scriptions. / am satisfied, after careful ex-
animation, that the latter exceed the former
ten to one, and that the services OF the
coroner are not oftener required is due alone
to a fact notorious in the profession, that
a competent druggist carefully studies every
prescription calling for powerful drugs, and
himself corrects the doctors mistakes. One
serious error by a druggist winds up bis busl-
ness in rapid order. There is no one to stand
between the incompetent druggist and bis vic
tim, but the careless doctor can depend with
reasonable assurance upon the strong prob
ability that if his figures are wrong and the
dose Of the drug is double what it should be,
the pharmacists trained eye will detect the
slip or the ignorance and put in the right
quantity.
asked a prominent druggist the other day
il he often had to correct prescriptions. de
smiled. Il never correct a physicians pre-
scription,n he replied. MY business is phar-
macy, not medicine"
"But in case you got an order calling for
ten grains of strychnine, to be taken at
onceE'
Il would not fill it. l would send it back
to the physician with polite note of inquiry.
That would be the retort courteous"
do you examine all prescriptions you
compound with view to possible errorsF
Certainly. Every druggist is compelled
to do that in self protection. For example,
here is a prescription sent here a few weeks
ago
Now this, as you see, called for twenty
pills Of sulphate Of morphine, gelatine coated,
each to contain two grains"
did you refuse iti7
@No, filed it-and there was no funeral
followed. 1 gave ten two-grain pills Of sui
phate of quinine, gelatine coated, for / knew
that 70 be what the physician intended to
prescribe. He is getting little old now and
sometimes makes slip of that kind, but We
always manage 10 set it right. About four
months ago one Of my clerks brought me a
prescription calling for one gramme of BIZ
chloride Of mercury, or corrosive Sublimate,
in eight pills. a gramme is sixteen grains,
which would have made the dose two grains
in each pill-enough to kill an elephant. l
sent the prescription TO the physician. He
erased gramme and wrote grain, even then
prescribing the maximum dose of the drug
one-eighth Of grain"
"Could not gramme be easily mistaken for
grainr
Most easily. Gramme is usually abbrevi-
ated thus, 'gm.,' while grain is 'gr.' Many
physicians use the metric system, and specify
the weight in grammes. Now, if only one
no
read gr., aud the patient will get only one
sixteenth Of the amount intended, or, vice
versa, he may get sixteen times too much
The latter case is not so probable, for the
druggists knowledge Of doses would inter
fere. But such a prescription falling into
the hands Of an ignorant clerk could easily
furnish business for the undertaken and no
one be the wiser"
"How often is the Judgment of the druggist
called into play over such questionsl"
with US it is a matter of almost daily oc-
currence, but Of course we handle large
number OF prescriptions. Most Of the puzzles
are due to the wretched handwriting affected
by some doctors"
asked another leading uptown druggist
concerning his experience with errors in pre-
scriptiOns.
~They have numbered hundreds" he said,
"but as we invariably refer them back when
illegible OF calling for more than the maxi
mum dose given in the dispensatory the con-
sequence does not fall upon the patient"
How do the doctors behave when advised
of their mistakesf
SSome take it kindly; others try to bluff
the case through by saying that heroic doses
were required; others get angry. sent one
prescription back to an eminent professor in
this city. 1t called for half grain of strych-
nine to the dose he tore it up, withdrew
his patronage and wrote us an indignant let
ter, claiming that the prescription called for
only 1-25 Of grain. He had destroyed our
evidence and there the matter ended. One
night l got prescription calling for 40
grains Of i0dide OF potassium in three pow
ders, one to be taken every four hours The
regular dose of iOdide is from five to ten
grains. I sent a messenger to inquire, and
the reply was the erasure of iodide' and the
substitution Of BROMIDE The least conse-
quence Of the iodide would have been furi-
Gus eruption all over the patient, to which
certainly his malady would not justly have
entitled him, as be was suffering from de-
hrium tremens."
do you have much trouble with quacksY'
@No. Quacks usually give very simple and
harmless remedies. They know their incom-
petence and constantly fear arrest for NAL
practice should an accident occur. The
quack, as a rule, confines himself to light
catharticS, tonics and lotions, giving child's
dose to an adult and trusting TO luck and ma
ture to effect a cure. Most Of them compound
their own nostrums and thus make double
profit, besides avoiding the placing of their
errors ON record 1t is the regular physician
and the physician Of high standing who is
most apt to be careless"
Another evil to which my attention was
called is the habit Of some physicians instead
Of specifying the dose and the time for its
repetition, TO give simply this general order:
"To be used as directed" Perhaps several
medicines have been ordered. The invalid
may re in charge Of an ignorant or forgetful
nurse to whom this gives discretionary pow
ers which may easily become fatal l saw
myself prescription calling for Majendie's
solution of morphia and marked in this way.
Was not this criminal careleSsnessl
Medicines are often kept in the household
after tho illness for which they were pre-
acribed has terminated. The direction Of the
physician has lo2g since been forgotten.
Another member OF the family, perhaps a
child, is taken down with some petty com
plant, and the quondam patient prescribeS q
dose Of the remedy used in his own case.
How much shall he givel lie looks at the bot
tie: use as directed" he thinks he remem-
bers having taken tablespoonful, so he adj
ministers that quantity The sufferer grows
rapidly worse. The doctor is sent for and
finds case Of morphine poisoning. The
bottle is produced. The doctor sees "Use as
directed" and diScreetly holds his peace.
Perhaps death follows, and no one is the
wiSer.-New York World.
Daniel ]. Rudd conducts, at Cincinnati
the only colored Roman Catholic newspaper
IN the United States. He is q young man
End tine orator.